Classification of colorectal carcinomas with regional lymphatic metastases

According to the UICC classification of colorectal patients with histologically confirmed regional lymph node metastases (pN1) are not further subdivided. In these patients, however, subgroups with widely differing prognosis can be established. A number of classifications proposed to cover these patients are discussed. The analysis of the Erlangen case material shows that it is decisive for the prognosis to know whether involved lymph nodes are located only at the branches of the supplying vessels ("peripheral"), or whether the lymph nodes along the trunks of these vessels ("proximal") are also involved. Among the patients with proximal lymph node metastases, the question as to whether the lymph node at the margin of the resected lymph drainage area ("marginal node") is involved or not, has no essential influence on the prognosis. The counting of metastatic lymph nodes does not represent an essential criterion for prognosis.